Post Detail

Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia (CAPTURA) is a project funded by phase 2 of the Fleming Fund through UK Aid and managed by Mott MacDonald. The Fleming Fund Regional Grant aims to strengthen the quality, quantity, analysis, and dissemination of antimicrobial resistance (AMR) data in South and South-East Asia. The project focuses on improving data collection methodologies, enhancing surveillance system performance monitoring, reinforcing data management practices, including linkages with clinical data, and supporting strategic planning for sustainable surveillance in the human health sector.

Led by the International Vaccine Institute (IVI), the CAPTURA consortium brings together partners with expertise across key areas: Brigham and Women’s Hospital (WHONET), the National Centre for Antimicrobial Stewardship (NCAS), the Heidelberg Institute of Global Health (HIGH), and SwipeRx Pte. Ltd.

Central training for the National Antimicrobial Prescribing Survey (NAPS), developed by NCAS, was successfully conducted in Bangladesh, December 2024, marking a key milestone under the CAPTURA initiatives. Held at Hotel Amari in Dhaka, this foundational training event supported national efforts to improve antimicrobial stewardship and strengthen surveillance of antimicrobial use (AMU) within hospital settings.

Launched in Bangladesh in November 2024, the second phase of CAPTURA  supports building sustainable AMU surveillance models through targeted capacity building, piloting standardised data collection tools, and promoting national ownership of hospital AMU data systems. CAPTURA collaborates closely with NCAS ─ a key partner in hospital-based AMU surveillance ─ alongside national stakeholders such as the Communicable Disease Control (CDC) division and the Institute of Epidemiology, Disease Control and Research (IEDCR) under the Directorate General of Health Services, and the Directorate General of Drug Administration under the Ministry of Health and Family Welfare, with support from the Fleming Fund Country Grant to Bangladesh.

As part of these efforts, Bangladesh piloted the NAPS tool in selected hospitals. The tool enables them to systematically assess antimicrobial prescribing practices, identify areas for improvement, and align with both national and global stewardship goals.

The successful rollout of the NAPS pilot in Bangladesh, piloted as part of the government’s broader efforts to strengthen national AMU surveillance systems, culminated in a central training workshop aimed at equipping key health personnel with the knowledge and skills to conduct effective audits of antimicrobial prescribing practices.

The NAPS tool is designed to:

• Provide a snapshot of antimicrobial prescribing across hospital wards.
• Assess prescribing compliance with national or local treatment guidelines.
• Identify inappropriate or unnecessary antimicrobial prescriptions.
• Benchmark hospitals against local and international best practices.

By applying the NAPS tool, Bangladesh aims to improve antimicrobial stewardship practices, reduce unnecessary antibiotic use, and contribute high-quality data to the global understanding of AMU trends.

Training overview: The training brought together participants from four selected pilot facilities:

• Shaheed Suhrawardy Medical College and Hospital (1350-Bed)
• Faridpur Medical College Hospital (500-Bed)
• Chattogram General Hospital (250-Bed)
• Daudkandi Upazila Health Complex (50-Bed)

Participants included representatives from authorities, including IEDCR, CDC, and Fleming Fund Country Grant, hospital focal persons, survey managers, and data collectors nominated by their institutions, along with national consultants from CAPTURA Bangladesh.

Training objectives:

• Introduce the structure, goals, and methodology of the Hospital NAPS audit.
• Train participants on clinical assessment of antimicrobial prescribing practices.
• Demonstrate the use of the NAPS digital platform for data entry and reporting.
• Clarify clinical definitions, guideline compliance criteria, and appropriateness assessments.
• Build capacity for conducting facility-level audits and supporting national AMU surveillance.

Training components:

• Introduction to AMR and AMS, overview of NAPS methodology, hands-on training using paper forms.
• Live demonstration and guided use of the NAPS web portal, mock data entry, troubleshooting, and group discussions.
• Case-based exercises, Q&A sessions, and role-specific breakout groups.

Participants received printed and digital toolkits, including audit forms, clinical assessment guides, and data entry manuals.

Collaboration and support

The successful delivery of the NAPS Central Training in Bangladesh was made possible through close collaboration between national and international partners, underscoring the importance of multi-stakeholder engagement in strengthening antimicrobial stewardship efforts. The training was led by the expert team from NCAS, based in Australia. Their deep expertise in antimicrobial prescribing surveillance and stewardship was instrumental in ensuring that participants gained a clear and practical understanding of the NAPS methodology and audit process.

Technical facilitation and coordination were provided by IVI and the CAPTURA Bangladesh team, who ensured contextual alignment, logistical support, and active engagement with local stakeholders. This joint effort not only enhanced the quality of the training but also fostered a collaborative environment conducive to learning and knowledge sharing. The structured and responsive support system was designed to empower participating hospitals to confidently conduct the NAPS audits and uphold data quality standards throughout the implementation phase.

Participant feedback

Participants of the NAPS training expressed strong appreciation for the practical, hands-on approach, noting that it enhanced their understanding of the audit methodology and prepared them to implement it effectively within their healthcare settings. They emphasised the relevance of the training content to their daily work and recognised the potential of NAPS to improve antimicrobial prescribing practices and support broader stewardship efforts.

The collaborative and interactive training environment fostered peer learning, encouraged open discussion, and helped build confidence among clinical and audit team members. Overall, participants found the training informative and empowering, laying a solid foundation for effective AMU surveillance in their facilities.

Strong foundation

The NAPS Central Training laid a strong foundation for the successful implementation of antimicrobial prescribing audits across the four selected pilot facilities. By equipping participants with the necessary technical knowledge, practical skills, and standardized tools, the training ensured consistency and quality in data collection during the audit phase.

One of the most significant outcomes of the training was the establishment of a core group of trained professionals who are now well-positioned to support NAPS’s audit independently. These individuals serve as key resources within their respective institutions and can contribute to the broader national agenda on combating AMR.

Acknowledgement

We extend our sincere appreciation to all individuals and institutions whose contributions made the NAPS Central Training a success.

We would like to acknowledge the NCAS, Australia, for leading the training and sharing their technical expertise and global experience in antimicrobial prescribing surveillance. Their guidance was instrumental in equipping participants with the knowledge and skills needed to effectively implement the NAPS methodology.

We also recognize the invaluable support of national stakeholders, including the CDC and IEDCR, for their leadership and collaboration in aligning the training with national priorities.

Special thanks to the CAPTURA Bangladesh team for their technical facilitation, logistical coordination, and continued support throughout the planning and execution of the training, as well as their commitment to strengthening AMU surveillance in Bangladesh.

Our gratitude extends to the participating hospitals for nominating dedicated focal persons and staff, and to all training participants for their enthusiastic engagement, commitment to learning, and active contribution to the future of antimicrobial stewardship in Bangladesh.

This collective effort reflects a shared commitment to addressing antimicrobial resistance and promoting data-driven, sustainable improvements in healthcare.

Written by: Hridika Talukder Barua (Consultant, CAPTURA Bangladesh) and Mohammad Julhas Sujan (Data Scientist, IVI).

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